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AmnioText Patch

New Hampshire rates for HCPCS Q4247

AmnioText Patch, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

Facilitymedian $3,162 · 10th–90th $132$3,7150%20%10th90th$3,162Professionalmedian $525 · 10th–90th $126$3,1620%20%10th90th$525$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$3,162.28
Typical High
$3,715.35
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$3,162.28
Typical High
$3,715.35
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$177.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$251.19
Typical High
$338.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$851.14
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$190.55
Typical High
$524.81
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$144.54
Typical High
$162.18